Provider Demographics
NPI:1982728242
Name:HOFFMAN CHIROPRACTIC CENTER, PC
Entity Type:Organization
Organization Name:HOFFMAN CHIROPRACTIC CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:636-477-8818
Mailing Address - Street 1:3864 MEXICO RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-3041
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:636-477-8012
Practice Address - Street 1:3864 MEXICO RD
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-3041
Practice Address - Country:US
Practice Address - Phone:636-477-8818
Practice Address - Fax:636-477-8012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005025111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0004637868OtherAETNA PROVIDER ID
MO177348OtherBLUE CROSS BLUE SHIELD
MOP00074843OtherMEDICARE RAILROAD
MO119319OtherHEALTHLINK PROVIDER ID
MO125771OtherHEALTHPARTNERS
MO167305OtherGROUP HEALTH PLAN
MO167305OtherGROUP HEALTH PLAN